The impact of ObamaCare on doctors and patients, companies inside and outside the health sector, and American workers and taxpayers

Democrats are increasingly acknowledging that the Affordable Care Act has an affordability problem.

Former President Bill Clinton said recently that people who are ineligible to get subsidies to buy ObamaCare insurance are “getting killed.”

Minnesota Gov. Mark Dayton said this month that “the reality is the Affordable Care Act is no longer affordable to increasing numbers of people.”

Even President Obama said in a speech last week that “there are going to be people who are hurt by premium increases.”

The core problem with President Obama’s most recent speech in defense of his health care law was not that he simply overestimated the merits of Obamacare. It’s that he refused to acknowledge that conservatives have reasonable disagreements with him about the direction of health care policy. President Obama claims that Republicans have offered no alternatives to the health care law when they have in fact outlined their own far-ranging plans for health policy. President Obama believes that only comprehensive insurance policies are real insurance. Conservatives generally believe, by contrast, that people should be free to buy cheaper policies that protect them only from financial catastrophes arising from their health needs.

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States are beginning to turn to hospitals to cover the cost of Medicaid expansion once the federal match begins to drop next year. The Affordable Care Act provides 100% federal financing for those made newly eligible for Medicaid under the law. The federal match rate falls to 95% in 2017, 94% in 2018, 93% in 2019, and then 90% in 2020 and beyond. Starting next year, eight of the 32 states that have expanded Medicaid planned to use provider taxes or fees to fund all or part of the states’ share of costs, the report said. These states have chosen to implement a new or modify an existing provider assessment specifically for the purpose of covering the costs of expansion.

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Democrats are already looking beyond ObamaCare’s slow-motion failure, and Colorado is showing where many want to go next: Premiums across the state are set to rise 20.4% on average next year, and some have concluded that the solution is more central planning and taxation. Voters will decide on Nov. 8 whether to try the single-payer scheme that blew up in Vermont.

Amendment 69 would alter the state’s constitution to create a single-payer health system known as ColoradoCare. The idea is to replace premiums with tax dollars, and coverage for residents will allegedly include prescription drugs, hospitalization and more.

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When Illinois’ Obamacare co-op went belly-up last month, Valerie Kincaid faced losing not just her insurance but her team of cancer doctors, too.

For six years, the 41-year-old leukemia patient has relied on doctors at Northwestern Memorial Hospital in downtown Chicago to keep her disease at bay. Once a month, she visits the hospital to receive an oral therapy that keeps her chronic lymphocytic leukemia under control and allows her to live a relatively normal life with her husband, Brian, and her 11- and 13-year-old sons.

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Despite significant challenges the Affordable Care Act has imposed on the U.S. health care system, President Obama defended his signature health care law in a speech on Thursday that described his pride in the law and acknowledged significant challenges his successor will face. Republican lawmakers pointed to some of the law’s challenges during the speech. “Obamacare is collapsing. Insurance companies are abandoning the program, leaving stranded families to face higher premiums and fewer choices,” said Wyoming Republican Sen. John Barrasso, in a statement sent out about halfway through the remarks.

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A new study in the New England Journal of Medicine suggests that the assumption that the ACA would lead to lower Emergency Room use was wrong as Medicaid expansion in Oregon produced a spike in ER visits. A surge in ER use will likely produce adverse health consequences for many and may be contributing to skyrocketing Medicaid expansion spending, which was 49% higher per enrollee in 2015 than the government expected.

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Bob Kocher and Ezekiel Emanuel, who worked in the Obama White House on health care reform, argue that it’s “misleading” to raise concerns about the fact that individual market health insurance premiums have nearly doubled under Obamacare. “Premiums today,” they say, “are 20% lower than the Congressional Budget Office predicted when the ACA was passed.” Their argument is nonsensically out of touch, and it illustrates why the designers of the ACA got so many things wrong. The unaffordability of exchange-based insurance is the ACA’s most serious problem. As research from Avalere Health has shown, enrollment in ACA-based insurance is alarmingly low among those whose incomes exceed 200% of the federal poverty level.

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President Barack Obama delivered a robust defense of Obamacare on Thursday, but also acknowledged his signature domestic achievement needs fixes as premiums rise and insurers are fleeing the law.

Obama hailed the achievements of the federal health care law six years after passage, providing coverage to an additional 20 million Americans and reducing the uninsured rate to the lowest level ever recorded. And he sought to remind Americans that they likely benefit from the law’s consumer protections, even though just a small fraction of the country actually buys coverage from Obamacare’s insurance marketplaces.

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Less than half of the approximately 27 million uninsured people in the U.S. are eligible for federal financial assistance, an analysis released Tuesday by the Kaiser Family Foundation shows.

Roughly 11.7 million, or 43 percent of that population, are not taking advantage of some sort of federal assistance to get health insurance that they are eligible for, according to the analysis. That assistant may be in the form of a subsidy to purchase a policy on the Affordable Care Act exchange or a Medicaid plan a consumer is eligible for but not signed up for.

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